The Injured Motorcyclist and the Unconscious Passenger
You are the first to arrive at a collision on a straight road in daylight. A motorbike has collided with a small car at a junction. The rider is lying on the road, conscious, complaining of pain in the neck and one leg, and is trying to sit up. Inside the car, the driver is slumped over the wheel and does not respond when you call. The car's engine is still running and you can smell fuel. There is a small amount of traffic approaching from both directions. You have a mobile phone and a basic first-aid kit in your vehicle. No other help has arrived yet.
1. List the immediate hazards you must manage before giving first aid, and how you would manage them.
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Hazards include moving traffic, the risk of fire from the fuel smell and running engine, and further injury to the casualties. Manage them in this order: switch on your hazard lights and position your vehicle to shield the scene if it is safe to do so; ask approaching drivers to slow or stop and, if possible, have someone warn traffic from the far side; if you can safely reach the car, turn off the ignition to reduce fire risk, but do not do this if it puts you in danger. Keep bystanders back and do not smoke or create sparks. Only once the scene is as safe as you can make it should you approach the casualties.
2. How should you handle the conscious rider who wants to sit up?
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The rider has neck pain after a collision, so a spinal injury must be assumed until proven otherwise. You should gently encourage them to stay still and not sit up or try to stand, and support their head in the position you found it rather than moving it. Keep them calm, reassure them and keep them warm. Do not remove the helmet unless it is obstructing their breathing and you have been trained to do so, because removing it can worsen a neck injury. Ask about pain and sensation in the limbs, and monitor their breathing while waiting for help.
3. What should you do for the unresponsive driver, and in what order?
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An unresponsive casualty takes priority. Check that the scene is safe, then check whether the driver is breathing - look, listen and feel - and check for a pulse. If they are breathing, support the airway and keep them still, monitoring continuously. If they are not breathing normally, call the emergency services immediately and begin CPR if you are trained, continuing until help arrives or you are too exhausted to continue. Give the emergency operator clear details: location, number of casualties, the unresponsive driver and the fuel smell. Do not move the driver unless there is an immediate danger such as fire.